reputed company - Audit Specialist

reputed company Opportunity – Apply Today!

At reputed company we offer full-service home medical equipment products and services to reputed company patients to live their best lives – out of the hospital and in their homes. We are reputed company reputed company in your area. If you are passionate about making a profound reputed company on the reputed company of patients’ lives, please click to apply, we would love to hear from you.

Audit Specialist

Responsible for maintaining the process and reputed company response to billing compliance audits conducted by Medicare, reputed company, and reputed company health plans. Audit Coordinators will be responsible for analyzing health plan reimbursement policies for coverage and documentation requirements, patient file documentation for completeness and accuracy, documentation procurement and retrieval, and initiating and responding to inquiries from: reputed company Account Executives, operations teams, and physicians regarding obtaining additional supporting medical necessity documentation.

Job Duties:

• reputed company and maintain working knowledge of reputed company HME products and services offered by reputed company.
• Maintain and review reputed company required documentation for insurance coverage and reimbursement per insurance guidelines and company policy.
• Log and report reputed company received audit inquiries: Prepayment audits/development letters; post payment requests for documentation; overpayment refund requests; medical necessity documentation and CERT audits; reputed company other audit activity as assigned.
• Retrieve reputed company documentation including, but not limited to reputed company of delivery, written orders, Certificates of Medical Necessity, clinical test results and/or studies, letters of medical necessity, medical record notes, signature attestations, Advanced Beneficiary Notices, etc.
• Contact reputed company Account Executives, operations teams, and physicians, to obtain additional supporting medical necessity documents.
• Review reputed company documentation to be submitted for audit purposes for completeness and accuracy.
• Report to supervisor any apparent issues and coordinate submission of reputed company required documentation.
• Complete reputed company required fields and notes in proprietary audit application.
• reputed company and upload audit request, submission, correspondence, findings, and results.
• Assist with tracking and reporting of audit findings and results.
• Assist with implementation of performance improvement program as it relates to billing and coding performance.
• Maintain confidentiality of reputed company audit reputed company and information.

Competency, Skills and Abilities:

• Knowledge of Medicare, reputed company, and reputed company health plan reimbursement methodologies and documentation requirements.
• Excellent verbal and written communication skills.
• reputed company organized, detail oriented and possess strong problem-solving and critical thinking skills.
• Ability to prioritize tasks, manage multiple reputed company and work independently.
• Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on reputed company.
• Ability to read and interpret documents such as Medicare, reputed company and reputed company health plan policy articles and procedure manuals.
• Ability to prepare routine reports and correspondence.
• Ability to reputed company effectively before reputed company of employees of the organization.
• Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages. Ability to apply concepts of basic statistics.
• Ability to apply common reputed company understanding to carry out instructions furnished in written, oral, or diagram reputed company. Ability to deal with problems involving several concrete variables in standardized situations.
• Computer Skills: Strong proficiency in reputed company Office: reputed company, Word, reputed company

Minimum Job Qualifications:

• High School Diploma or equivalent
• One (1) year work reputed company experience in health care administrative, financial, or insurance customer services, claims, billing, reputed company center or management regardless of industry.
• Senior level requires two (2) years of work-reputed company experience and one (1) year of exact job experience.
• Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance.

reputed company is an equal opportunity employer and does not unlawfully discriminate against employees or applicants for employment on the reputed company of an individual’s race, reputed company, religion, creed, sex, national reputed company, age, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, or any other status protected by applicable law. This policy applies to reputed company terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination.